Compensatory wayfinding behavior in topographic disorientation from brain injury

Recent studies of topographic disorientation from brain injury have focused on describing impairments, detailing neuroanatomical correlates of topographic disorientation, and classifying types of topographic disorientation. Normative models of environmental cognition have been applied in some studies of topographic disorientation, but more work is needed in this area. Few studies have produced data on everyday functioning with topographic disorientation. This paper presents data on compensatory wayfinding behavior in familiar environments, collected through case studies of three individuals with topographic disorientation from brain injury. Structured tests were used to evaluate visuo-spatial impairment, and normative models of wayfinding guided semi-structured and open-ended questioning about wayfinding inside and outside the home. All three-study informants were able to wayfind successfully within the home, though they varied in their ability to travel independently outside the home. Landmarks and scanning were important for orienting for all three subjects. The two subjects who were most able to travel independently also used sequencing of landmarks, directional heading and body position as elements of their wayfinding strategies. The information presented in this paper may prove useful to rehabilitation specialists who are treating brain-injured patients by providing new ideas about methods of compensation, and may contribute to emerging theory regarding impairments of orientation, and normative models of wayfinding.